The Accordion: A Back Breaker

Part Five: Oh, My Aching Neck and Shoulders!

This article has been prompted by several accordionists who have called or
written me requesting advice about exercises to increase endurance or
strengthen shoulders and arms following injury or debility because of the
long lay-off in playing. My advice to those who have had upper extremity
injuries is to seek medical help and appropriate rehabilitation from their
medical doctor, who can guide them to the best qualified medically
approved source for physical recovery.

However, playing the accordion has its specific challenges and needs
physically, which generally is poorly understood by medical personnel who
are not accordionists and are thus likely to give you the standard advice
"if it hurts don 't do it." This is not what accordionists want to hear!
I often am told by those players who are plagued by back or neck problems
that their doctors (or chiropractors) have insisted they don't play.

What the good doctors don't explain
fully
is that in most cases it is not the act of playing the accordion that is a
possible source of irritation. Rather, it is the fact that one is sitting!
Sitting is a real challenge and primary source of aggravation to the low
back. The accordion plays no part in this as it is strapped on close to
the body and is balanced on the upper thighs. There is absolutely no
increase in low back pressure when the accordion is balanced in a proper
playing position. (Unless you are one of those few who wears their
accordions half-way down their chests!)

The only detriment to playing with a painful or stiff low back is 1)
sitting to play and 2) the act of taking the instrument out of its case. A
word of caution: standing up to play does put a considerable loading on
the low back and the neck and shoulders and should be avoided whenever
possible.

With regard to the neck, a properly positioned accordion poses no problem
if one is not standing and if the accordionist keeps his or her head up by
positioning the music stand at eye level height and does not constantly
strain to look at the keyboard while playing. Make sure also that you have
wide, well padded straps over the shoulders. A good set of well-made
straps is a sound health investment. It goes without saying that many
professional accordionists who perform standing up eventually have trouble
with their necks ranging from stiffness and headache to the more serious
numbness and tingling in the hands and fingers that arises from nerve
compression in the lower neck. If you experience tingling in the fingers,
seek your doctor's advice quickly. In a future article, I shall discuss
the different types and distribution of numbness and tingling that can
occur so that. you will understand what may possibly be causing it.

To get back to helping you get strong in the shoulders and arms following
surgery, injury, or general weakness after a long lay-off, I have some
general exercise programs which you can perform at home. Or perhaps you
would like to increase your strength and endurance to better master
bellows technique and improve control of your accordion. These exercises
will also do that.

There are two objectives built into the program of exercises that follows
this discussion.

1) To perform high quality effective exercises, one must work toward a
full or adequate joint range of motion without any sharp catching pain.
Sharp pain during exercise is a warning sign. Seek your doctors advice,
preferably a physician who is familiar with exercise physiology or
specializes in physical medicine ie: a physiatrist. Alternatively, seek
help from a physical therapist who specializes in manual therapy.

2) To work toward building strength and endurance, not muscle bulk like a
weight lifter. To achieve, this keep in mind that the key is to do lots of
repetitions with a low weight or resistance if exercising with upper body
equipment like wall pulleys or gymnasium equipment at a health club. If
you have a special problem, write to me and I will do my best to point you
in the right direction.

First, a little essential anatomy for those of you who are curious and
want to understand why you do these exercises. If you are not curious and
just want to get on with the exercises, skip this part. At this time we
are focusing purely on the shoulders which do the work of manipulating the
instrument.

Most strength and endurance is required in the left shoulder and arm
because of bellows action. To pull the bellows out we use two main muscle
groups. The hard working shoulder external rotators, for example,
infraspinous muscle and secondarily the shoulder abductors (moving away
from the body) like supraspinatus and the deltoid muscle. Keep in mind
that many other muscles also work to stabilize and support the head, neck
and upper body while this action is taking place.

To push the bellows in we use the strong latissimus dorsi muscle and the
pectorals mainly as well as the internal shoulder rotators of which the
subscapularis muscle is the most important.

For the right hand, good strength and endurance must be preserved to
sustain the proper shoulder-arm-wrist position. The main group for this is
the shoulder abductors namely deltoid, and secondarily supraspinatus. The
deltoid muscle is easy to find. Place your hand over the outside
upper-most part of your shoulder joint. Now lift your arm away from your
side. You will feel the deltoid muscle fibers contract. With sustained
playing, deltoid is required to remain contracted for a long period of
time. Fortunately, this muscle is seldom injured, but it can become weak
through non -use or debilitation. It is a very important muscle for the
right hand keyboard.

Here are a collection of do-it-yourself exercises with suggested
repetition rates, which should help you improve strength and endurance, to
assist you in managing the accordion. Remember, start out slowly and
gently, building repetitions gradually. Any questions, please write to me
care of Accordion World, 16323 S.E. Stark, Suite 2, Portland, OR 97233.
Good luck!

Reprinted from Accordion World, (Portland, Oregon: June 1994).
Used with permission.

The Classical Free-Reed, Inc. staff gratefully acknowledges
volunteer Terry Knight who assisted in the production of this
article.